Provider Demographics
NPI:1801816707
Name:IWUCHUKWU, JENNIFER F (CNM)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:F
Last Name:IWUCHUKWU
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4544 SOUTH KING DRIVE
Mailing Address - Street 2:1ST FLR.
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60653-4115
Mailing Address - Country:US
Mailing Address - Phone:773-268-1020
Mailing Address - Fax:773-268-1020
Practice Address - Street 1:1901 W HARRISON ST
Practice Address - Street 2:SUITE 4453
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3714
Practice Address - Country:US
Practice Address - Phone:312-864-4184
Practice Address - Fax:312-864-9369
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife